Healthcare Provider Details

I. General information

NPI: 1144089046
Provider Name (Legal Business Name): ZAREK DONOHUE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2024
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3411 SILVERSIDE RD STE 103
WILMINGTON DE
19810-4812
US

IV. Provider business mailing address

3411 SILVERSIDE RD STE 100
WILMINGTON DE
19810-4811
US

V. Phone/Fax

Practice location:
  • Phone: 302-543-5454
  • Fax:
Mailing address:
  • Phone: 302-543-5454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0404X
TaxonomyCardiac Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERESA NICHOLS
Title or Position: BILLING MANAGER
Credential:
Phone: 302-543-5454